Intra-Aortic Balloon Pump Therapy
 
 

Intra-Aortic Balloon Pump Therapy

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Intra-Aortic Balloon Pump Therapy

An intra-aortic balloon pump (IABP) is a type of therapeutic device. It helps your heart pump more blood. You may need it if your heart is unable to pump enough blood for your body.

The IABP has several parts. One part is a thin, flexible tube called a catheter. Attached to the tip of the catheter is a long balloon. The balloon is inserted into your aorta. The aorta is the very large artery leaving your heart. The balloon is called an intra-aortic balloon, or IAB. The other end of the catheter attaches to a computer. This computer tells the balloon to inflate and deflate at the right time when your heart beats.

In many cases, this procedure is done through a small cut on the inside of your upper leg. Your health care provider will insert the balloon pump catheter into an artery in your leg. He or she will then guide it to your aorta.

From there, the IABP can start to do its work. The balloon is set to inflate when the heart relaxes. It pushes blood flow back toward the coronary arteries. They may not have been getting enough blood without the pump. When the heart contracts, the balloon deflates. That allows the heart to pump more blood out to the body while using less energy. The device continues to inflate and deflate until it is removed.

Why intra-aortic balloon pump therapy is done

IABP therapy is used to treat cardiogenic shock. That’s when your heart can’t pump enough blood to meet the needs of your body. Some heart problems can cause cardiogenic shock. These include:

  • Unstable angina

  • Heart attack

  • Certain abnormal heart rhythms

  • Heart failure

  • Heart defects

You may also need an IABP if you have a certain medical procedure. For example, you may need it if you have a percutaneous coronary intervention. This procedure opens a blocked artery in the heart. You also might benefit from an IABP if you have heart surgery.

Risks of intra-aortic balloon pump therapy

IABP therapy can be very helpful. It can sometimes even be life-saving. But it does have some risks. These include:

  • Damage from the lack of blood flow to a limb (ischemia)

  • Injury to an artery

  • Rupture of the balloon

  • Incorrect position of the balloon. This might cause injury to the kidneys or other problems.

  • Low platelet count. This might cause excess bleeding, because your blood doesn’t clot as well.

  • Infection

  • Stroke

Your risks depend on your age and your overall health. For example, a lack of blood flow to your leg may be more likely if you have peripheral vascular disease. Talk with your health care provider about which risks apply most to you. Talk with your health care provider about any concerns you have.

Getting ready for your procedure

Before your procedure, your health care provider will give you detailed instructions. Be sure to tell your health care provider if:

  • You are pregnant or think you might be pregnant

  • You have other medical conditions

  • You have ever had a problem with sedation

  • You have new symptoms, such as a fever

If you smoke, you should stop before your procedure. You may also need to stop taking any medicines, vitamins, or other supplements. You may also be given some new medicine to take before and during the treatment. This may include medicine to help prevent blood clots.

On the day of your procedure

IABP therapy may be done during another type of heart surgery. In an emergency, a medical team may insert it at your bedside.

Each person’s procedure can vary. Your health care provider can tell you how yours will be done. In general, you can expect:

  • You’ll be given anesthesia. If you are having the procedure during surgery, you may already be under general anesthesia. In that case, you will be asleep and won’t feel anything. In other cases, you may receive medicine to help you relax. You will also receive numbing medicine at the insertion site.

  • During the procedure, your heart rate, blood pressure, and other vital signs will be watched.

  • A small cut will be made through an artery in the upper part of your inner thigh. The balloon catheter will be inserted there.

  • A surgeon will gently push the catheter to a part of the aorta in your chest. He or she will use continuous X-ray imaging to track movement of the catheter.

  • The balloon will be programmed to inflate with helium when your heart relaxes. It will deflate when your heart contracts

  • The end of the catheter will be secured, so it stays in place.

You may feel some chest pain after the procedure. It should go away within minutes of starting the IABP. If you are still having symptoms, you may need more treatment.

After your procedure

You may need to have the pump for several days. Your health care provider will monitor you. He or she may turn the pump off for a short time to see how your heart responds. Or he or she may set it to inflate and deflate with only every 2nd or 4th heartbeat. When your heart pumps well on its own, you may be ready to stop the IABP therapy. Or, you may stop the therapy when another treatment becomes available, such as a donated heart.

When it is time to remove the pump, you will likely get medicine to help you relax. Your health care provider will then remove the catheter and the balloon through the incision in your leg. He or she will also close up the incision on your leg.

Your health care provider may give you more instructions. Follow these carefully to help increase your chance of a good outcome.